Provider Demographics
NPI:1780880146
Name:THE VASHTI CENTER, INC.
Entity type:Organization
Organization Name:THE VASHTI CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QA DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:H
Authorized Official - Last Name:LOFTISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-226-4634
Mailing Address - Street 1:1815 E CLAY ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4736
Mailing Address - Country:US
Mailing Address - Phone:229-226-4634
Mailing Address - Fax:229-225-1093
Practice Address - Street 1:1815 E CLAY ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-4736
Practice Address - Country:US
Practice Address - Phone:229-226-4634
Practice Address - Fax:229-225-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAC10000012033251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health